September 30, 2004

This is a follow-up to a previous article (Schizophrenia newsblog post, Sept 27 2004) about new Medicare drug benefits, to be enacted in 2006. According to the formula that is currently on the table, the number of prescription drugs covered by Medicare will be severely limited. The insurance plan will only be required to include two medications in each therapeutic drug class. There are currently no guidelines that specify how many classes a plan must cover. This will potentially eliminate costlier (but possibly efficacious) medications in favor of cheaper ones. Responses to medications are highly individualized, particularly in the realm
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September 29, 2004

Researchers in Boston are to recieve almost $20 million from the U.S. government. Their mission: to improve brain scanning programs so that patients can be diagnosed and treated sooner. "The tools we're after would make diseases detectable at earlier stages when they're more curable," said Dr. Steven Seltzer, chairman of radiology at Brigham and Women's Hospital. The researchers are specifically looking to improve the software programs that interpret the brain images that come out of MRIs, CTs, and other types of scans. For example, better interprative software may be able to detect subtle gradations of color and brightness (certain patterns
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September 28, 2004

Dr. Peter Weiden and colleagues at SUNY Downstate Medical Center (NY) are implementing an approach to schizophrenia treatment that British doctors are already using with success - a treatment plan that includes both medication and talk therapy as essential elements. Medication is vital for stabilizing some symptoms of the disease; however, many people have trouble achieving a full recovery using medications alone. The current antipsychotics may only reduce symptoms in 60-80% of patients, and even among these, medication might not always control all symptoms adequately. For others, medications that have helped in the past may stop working. Says Weiden: "The
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September 27, 2004

Incidence of Newly Diagnosed Diabetes Attributable to Atypical Antipsychotic Medications Douglas L. Leslie, Ph.D., and Robert A. Rosenheck, M.D. Am J Psychiatry 161:1709-1711, September 2004 This is an article that attempts to clarify whether there is a direct relationship between diabetes and the use of atypical or second generation antipsychotics. Diabetes, which is a disease in which the body is unable to regulate the level of sugar in the blood, is important because it is a very strong risk factor for complications such as heart disease/heart attacks, blindness, kidney failure, limb amputations, and many other maladies. The prevailing wisdom, has
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September 24, 2004

A preliminary study of the antipsychotic drug olanzapine from researchers at the University of Pittsburgh Medical center indicates that it might benefit those with schizotypal personality disorder as well. Schizotypal Personality Disorder, or SPD, includes many of the social and cognitive deficits of schizophrenia (i.e. suspiciousness or paranoia, extreme social anxiety or withdrawal, odd thinking/speech, unusual perceptual experiences such as bodily illusions, etc). According to the American Description, it "does not occur exclusively during the course of schizophrenia", and the European Description asserts that in a diagnosis of SPD, "no definite and characteristic schizophrenic anomalies have occurred at any stage."
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September 23, 2004

A study out of the Tel-Aviv University in Israel identified a 5% suicide attempt rate among a pool of 792 elderly (defined as those over 60 years of age) patients who were admitted to the hospital for schizophrenia over a 10-year period. More alarming still is the ratio of attempted to completed suicide for this population - within the range of 1:4 - which is higher than in any other age group. Men appeared to be more prone to suicidal behavior than women (57% of attempts were made by men, as opposed to 43% by women). For the full
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Researchers from the University of Alberta have highlighted a troublesome lack in our support progams - specifically, a lack of any programs that address the unique needs of children affected by the mental illness of a brother, sister, grandparent, or parent. Schizophrenia has many troubling or frightening symptoms - among them hallucinations, delusions, intense paranoia, mood swings, emotional withdrawal, and apathy - that some, and particularly children, might assume are part of the ill person's natural personality. Children can suffer from the lack of a warm, nurturing relationship with their parent without ever realizing that it is caused by a
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September 20, 2004

We've just been informed of an excellent handbook that is available on the Internet. We encourage you to check it out and print it out for anyone you think might benefit from it. "Dealing With Cognitive Dysfunction Associated with Psychiatric Disabilities" - A Handbook for Families and Friends of individuals with psychiatric Disorders"
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Today's "Wired News" has a good story on the progress that is being made in genetic analysis. This technology is valuable because it will allow people to get a gene scan done on themselves to identify their level of predisposition towards different diseases - like schizophrenia or bipolar disorder - and then take appropriate actions to minimize getting the disease (such as avoiding street drugs, etc.). Here is a short excerpt from the story: "TAGCTAAGTCGGATT � the readout tells the story of your genetic makeup, and it will soon tell you what genes you carry, what mutations there are and
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Some studies (see "Leading Drugs for Psychosis Come Under New Scrutiny"in NY times, 05/20/03) have called into question the efficacy of the more expensive atypical antipsychotics, when compared with generic treatments such as haloperidol. According to a recent study from Washington University, which tracked results over three years (a longer period than the previous studies), switching to atypical antipsychotic medication may improve quality of life, symptom management, and adherance to outpatient treatment. 25 patients with chronic psychosis, all of whom had recently switched from a typical to an atypical antipsychotic, were evaluated over three years (via self-reporting) for symptom severity
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A recent study from Innsbruck University Clinics in Austria surveyed 61 patients with schizophrenia, to determine the subjective attitudes and concerns that affect their adherance or non-adherance to medication treatment. The study concentrated on analyzing four variables: the influence of patient attitude, the influence of clinicians/relatives inquiring about medication adherance, psychopathology, and side effects. Results showed that patients were most likely to adhere to mediction if: the drugs were percieved as having a positive effect on everyday life, psychiatrists enquired about drug intake, and psychological side effects were present. The first two variables make sense - clearly, a person is
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September 18, 2004

Research has shown that many genes are involved in the epidemiology and symptomology of psychiatric disorders such as schizophrenia and bipolar disorder. Perhaps RNA interference molecule, currently being investigated for the treatment of macular degeneration, may one day be of use in treating these and other brain diseases. This novel therapy, meant to turn off the abnormal or undesirable genes that cause certain diseases and symptoms, is set to be tested on patients suffering from macular degeneration. The experimental treatment is an injection of RNA interference (RNAi) compound, which has been shown to turn off genes in a laboratory setting.
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September 17, 2004

The following is a press release from Acadia Pharmaceuticals, detailing the clinical testing of a new drug that allegedly reduces some side effects associated with haloperidol, Zyprexa, Risperdal and Seroquel. As with all cases where you're getting information directly from the marketing department of a company - if you're interested in this drug you should seek additional information from an independent expert (for example your psychiatrist or doctor). SAN DIEGO, Sept. 15 ACADIA Pharmaceuticals Inc. (Nasdaq: ACAD), a biopharmaceutical company utilizing innovative science to fuel drug discovery and clinical development of novel treatments for central nervous system disorders, today reported
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According to an article in the American Journal of Psychiatry (2004:161:1324-1333), women may need different doses of antipsychotic medications than men. Although current prescription guidelines do not distinguish between males and females, this article points out that drug metabolism in general can vary based on gender. Morevoer, the normal fat ratio of women's bodies can affect how drugs are distributed to different organs. With schizophrenia in particular, previous research has indicated a difference in the general disease course between men and women. The article argues that due to these factors, women may need lower doses than men, particularly during pregnancy.
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September 15, 2004

Safety reporting in randomized trials of mental health interventions. Papanikolaou PN, Churchill R, Wahlbeck K, Ioannidis JP. Am J Psychiatry. 2004 Sep;161(9):1692-7. Prior to a medication being offered to the public there are scientific procedures known as randomized controlled trials (RCT) that are used to test the safety and effectiveness of a medication (Click here for more information about different types of clinical trials). In psychiatry, it is unclear of how adequate the reporting of safety information is in publications of randomized trials. As such, the authors for this study explored whether the reporting of safety information, including withdrawals due
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September 14, 2004

Insight and Its Relationship to Violent Behavior in Patients With Schizophrenia Buckley PF, Hrouda DR, Friedman L, Noffsinger SG, Resnick PJ, Camlin-Shingler K. Am J Psychiatry 161:1712-1714, September 2004 People with schizophrenia differ on the degree to which they are aware of having an illness and this can impact behavior. A small percentage of those with schizophrenia get violent and it seems that this violence is most likely to happen during periods of active psychosis. Doctors and legal experts go back and forth as to whether patients can be held accountable for such violent acts while they are actively psychotic.
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September 11, 2004

A new study in the American Journal of Psychiatry reports that the risk of developing new cases of diabetes mellitus from using atypical antipsychotic medications is small. Specifically, the study (which followed 56,849 patients on atypical antipsychotics for a period of two years) concluded that "[a]lthough clozapine and olanzapine have greater diabetes risk, the attributable risk of diabetes mellitus with atypical antipsychotics is small." These results may not be applicable to all populations; the subjects in this particular study were older, predominantly male patients in a VA hospital system. This research follows previous reports of increased diabetes risk due to
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Currently, there is no law requiring drug companies or other research entities to publish all data from their clinical trials. This can lead to biased reporting, as companies may only make public the most favorable studies. However, due to increasing criticism from patient and physician groups, this may soon come to an end. For example, a new piece of legislation meant to force total disclosure of research data may make an appearance on Capitol Hill this week. According to the bill, the Institutional Review Board (IRB) would require all studies of new therapies to register their trials in a public
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September 10, 2004

According to new research published in this month's Archives of General Psychiatry, cognitive rehabilitation can lead to major improvements for patients with stable schizophrenia. This is promising news, given the inability of most anti-psychotic medications to consistently or dramatically improve the negative, or social/cognitive, symptoms of schizophrenia. According to the research team, cognitive therapy is most beneficial to patients with controlled symptoms and reduced relapse risk, but with lingering social and cognitive deficits. In their study, the team examined the potential benefits of two types of cognitive therapy with a pool of 121 symptomatically-stable schizophrenia/schizoaffective disorder patients. The subjects recieved
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Stress Hormones could play role in schizophrenia New research suggests that the over-producuction of stress hormones could be responsible for physical changes to the brain in people with schizophrenia. In a world-first study of 18 to 24-year-olds at high risk of developing a psychotic illness, researchers at the Melbourne Neuropsychiatry Centre and Orygen Research Centre have found that those who develop schizophrenia have a larger pituitary gland at the base of their brains than those who do not develop the illness. This was also true for those who developed psychotic depression. Psychotic disorders such as schizophrenia are more likely to
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September 08, 2004

Recent research from the National Public Health Institute in Finland suggests that childhood-onset schizophrenia appears to be linked to more specific cognitive deficits than adult-onset, which involves more generalized deficits. Children with early-onset schizophrenia had poorer verbal memory function (according to testing with the California Verbal Learning Test, the Wechsler Memory Scale, and the Weschler Adult Intelligence Scalle) than older people with schizophrenia. The study included a total of 237 schizophrenia patients, ranging in age from 13 to 44 years. The specific verbal deficits included poorer word recall, poor ability to group words into appropriate categories, and poorer word recognition.
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Brandon Staglin had a bright and promising future. As a child, he skipped grades at school, had a perfect GPA, stellar test scores, and a high IQ. As a national merit scholar and with aspirations of being an astronautical engineer at age 18, his descent into schizophrenia was sudden and stunning to him and to those who knew him. Within his first week of showing symptoms, he was picked up by the police for wandering around the town of Lafayette and put in a mental institution. From the day his parents rushed home from a business trip in Paris to
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September 07, 2004

The following story is about a rare event where a person was diagnosed with schizophrenia but actually ended up having a brain tumor. It is very common for people who have schizophrenia to not understand that they have schizophrenia (upwards of 50% of people who have schizophrenia don't understand that they have schizophrenia) but occasionally the reverse it true. The lesson for all here is to make sure the psychiatrists do the proper medical diagnosis before you or someone you know is diagnosed with schizophrenia. Generally this is true - psychiatrists typically take quite a while to diagnose schizophrenia because
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As we've covered before in our Daily Schizophrenia Blog, the recent development of genetically alterred laboratory mice that develop schizophrenia may offer insights into the cause of schizophrenia. Here is a brief interview with one of the researchers involved: Q: What makes mice psychotic other than the looming presence of an unfriendly feline. A: In this case the rodents have genetically engineered mutations in two genes. Q: How do they know which genes to tweak? A: The mutations are the same as those found in a Canadian family with a history of schizophrenia. The genes concerned are called NPAS1 and
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This month, The Detroit Free Press is starting a three part series on Children in Crisis: Mental Health,". It is an important, but disturbing report - and is valuable reading for families, support groups, and especially public policy makers. The series, is available at www.freep.com/specials So far, Michigan has settled for a sort of mental health shuffle board. Some kids are lucky enough to have their problems spotted and be referred for managed mental health care. A great many, though, are far less fortunate. They either go un-cared for or are shuffled into juvenile detention, foster care or jails --
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New Medicare drug-benefit rules in the USA may impact You - The Government is Seeking Public Feedback. The Medicare Modernization Act, enacted last year and taking effect in January 2006, represents a fundamental change in the 40-year-old entitlement program. It creates a $ 400 billion prescription drug benefit for elderly people and some people with disabilities and gives private insurers a huge new role. For the first time, private-sector drug plans will administer the benefit through a competitive model One big issue for the mental health field is the way the benefit will treat people who quality for both Medicare
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Personal experience by families of people with schizophrenia suggests that even the electronic guns called Tasers (that are supposed to be harmless) can still be deadly. A father wrote this recently in a letter to the editor of the Arizona Republic: Taser analysis not so simplistic The writer's analysis is as shallow and misleading as Taser President Tom Smith's. The issue is not whether or not the Taser can be used in a high percentage of cases to reduce death and/or physical trauma to officers and civilians alike. The issue is whether or not it's OK to kill the rest
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Gene found to be connected with Schizophrenia and to Alzheimer disease This week Dr. D. Craig and colleagues, of Queens University Belfast, (Ireland) Department of Geriatric Medicine announced that they have found a link betweek the "Interleukin-1 beta" gene and Alzheimer disease. However, the explanation for why some patients develop psychotic change in Alzheimer disease is still unclear. "Psychosis-modifier genes" may act in the setting of neurodegeneration to produce Alzheimer Disease plus psychosis in a similar way to how genetic modulation during neurodevelopment leads to schizophrenia," the scientists in North Ireland report. "we tested the association between the functional interleukin-1beta
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Japanese Researchers announced this week that they've identified a link between the "Tryptophan hydroxylase" gene and childhood-onset schizophrenia ��� "We explored the relationship between the tryptophan hydroxylase gene polymorphism and susceptibility to childhood-onset schizophrenia in a Japanese sample. Subjects were 51 Japanese patients who met DSM-IV criteria for schizophrenia before age 16 and 148 Japanese healthy controls," scientists in Japan report. There was a nearly doubling of the risk for childhood-onset schizophrenia associated with the AA genotype compared to other genotype groups. Sekizawa and colleagues published their study in American Journal of Medical Genetics Part B - Neuropsychiatric Genetics (Childhood-onset
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There have been a number of recent anouncements (see earlier stories in our Daily Schizophrenia News blog - in May, if I remember correctly) that research teams in the UK and at Yale University - have developed the ability (with a high degree of accuracy - of 95% or higher) to identify the key brain changes that result in schizophrenia, well before (up to years before) the person shows outward signs or symptoms of schizophrenia (which it is now confirmed only become noticeable to most people well after the disease and the brain damage has progressed. This early diagnosis offers
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September 06, 2004

We've covered this before - but it always bears repeating. Pill-splitting saves money on certain medications. A month's supply of 50-milligram tablets of the antidepressant Zoloft retails for about $86. Unless you know a trick that can slash the price in half. Patrick Voight, a pharmacist at the Hassig Drug Store in Kansas City, Kan., knows that cutting a pill in half can slice a sizable portion from the pill's cost. Sometimes that's just what this pharmacist orders. Pill-splitting exploits a curious aspect of drug-pricing. Some drugs come in more than one dosage without much difference in price. That means
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Oosthuizen P, Emsley R, Turner HJ, Keyter N. A randomized, controlled comparison of the efficacy and tolerability of low and high doses of haloperidol in the treatment of first-episode psychosis The International Journal of Neuropsychopharmacology (2004), 7:125,131 This study was conducted to determine which of two doses of haloperidol (Haldol) would be more effective for patients who are new to schizophrenia. In America, we are quick to go to second generation antipsychotics like Risperdal or Zyprexa, but outside of the US, Haldol is still used frequently because of its cost effectiveness and its high potency. People often stay away from
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Goff DC, Bottiglieri T, Arning E, Shih V, Freudenreich O, Evins AE, Henderson DC, Baer L, Coyle J. Folate, homocysteine, and negative symptoms in schizophrenia. Am J Psychiatry. 2004 Sep;161(9):1705-8. This is an article that tries to look for an explanation for why patients with schizophrenia have negative symptoms. Negative symptoms are considered the symptoms of schizophrenia that can be very debilitating but are often inaccurately not thought of as the primary symptoms of the disorder. Examples of negative symptoms are a flat or blunted affect (affect is the way someone demonstrates their emotions externally), lack of motivation, poor personal
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September 05, 2004

A team from Indiana University-Purdue University Indianapolis suggests that the job performance of schizophrenia patients may be more affected by the extent of their cognitive impairments than on the availability of vocational rehabilitation. The team interviewed 112 schizophrenia patients enrolled in employment programs, and tested them for verbal learning and memory skills, attention, information processing ability, and executive functioning. After four months, results showed that patients with higher neuropsychological profile scores had better work behaviors, including work habits, personal presentation, work quality, social skills, cooperativeness, number of hours worked per week, and wages earned. Jovier Evans, primary investigator for the
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A UK research team reported in the British Journal of Psychiatry (2004:185:220-226) that psychosis is more common among people who have a significant number of traumatizing events in their past. The findings were based on a data analysis the 2nd British National Survey of Psychiatric Morbidity. The team concluded that such negative social events may play a role in the development of psychotic symptoms. In reality, it's difficult to determine cause and effect - perhaps the characteristics of psychosis bring about traumatizing events as a result, or perhaps people with psychosis report hallucinations they experience as real events. According to
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Affymetrix, Inc recently released the world's first clinical diagnostic microarray system, the GeneChip System 3000Dx. Development partners (such as Roche Diagnostics) partner with Affymetrix for the right to use their microarrays and tools. The company then develops genomic diagnostic tests. For example, with the Roche AmpliChip CYP450 Test, scientists can analyze variations in certain genes that affect the metabolizing rate of common drugs used to treat schizophrenia, depression, bipolar, cardiovascular disease, and others. Having this knowledge will help physicians choose proper drugs and dosages for different patients. For the full article, see "World's First Diagnostic Microarry System Launched by
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September 02, 2004

Pfizer issues Geodon warning Pfizer sent letters to physicians yesterday to notify them that its schizophrenia drug Geodon might cause coma and death. Pfizer has added a warning to the Geodon label stating that some patients have experienced hyperglycemia after using the drug. Patients with diabetes risk-factors, such as obesity or family history of diabetes, should be monitored for the duration of their use of Geodon, the letter said. In response to the revelations, the FDA has asked all manufacturers of atypical antipsychotic medications to add similar warnings.
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September 01, 2004

Lilly Announces Recipients of the 2004-2005 Lilly Moving Lives Forward Reintegration Scholarship; Program Helps People With Bipolar, Schizophrenia and Related Schizophrenia-Spectrum Disorders Reintegrate Into Society EDITORIAL NOTE: While this is a good start - Lilly earns billions of dollars from Zyprexa each year and our hope would be that they could offer a more extensive program than a scholarship program that is only for 50 people. We hope to see them expand the program in the future. Source: Lilly Press Release (produced by Lilly and Company): INDIANAPOLIS, Aug. 30 For the seventh straight year, Eli Lilly and Company (NYSE: LLY)
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A team of researchers at the University of Texas Southwestern Medical Center and Children's Hospital Medical Center in Cincinnati are studying genetically engineered mice that display abnormal social behavior, including running from their littermates. Researchers claim the behavior comes from defects in two genes, called NPAS1 and NPAS2. Similar mutations exist in a Canadian family with a history of schizophrenia. These key genes code for transcription factors (proteins that control the production of certain chemicals) found in inhibitory interneuron brain cells. The ultimate chemicals they affect are unknown at this time. The mice brains were found to be deficient in
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Although treatments for many psychiatric disorders are much improved in the last fifty years, the majority of sufferers still struggle to find something that consistently works for them. For example, in the estimation of Dr. Allen Roses, an academic geneticist from Duke University, only 60% of schizophrenia patients treated with medication respond (Source: "Glaxo chief - our drugs do not work on most patients." The Independent, Dec 8 2003. No details were given as to the type of medication administered, the length of time meds were taken, or other therapies concurrent with medication). If medication alone is still largely hit-or-miss,
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